Pediatricians offer strategies for talking to kids about bad news

Parents wondering how to talk to their children about tragedies such as natural disasters or terrorist attacks have a new resource to help them, published online in the medical journal JAMA Pediatrics.

“There have been a lot of changes in how we receive news and the types of news we receive, which has impacted the information that kids are exposed to,” said Dr. Megan Moreno, a pediatrician and adolescent medicine specialist at Seattle Children’s Hospital in Washington, who wrote the one-page primer intended for parents and other grown-ups.

The content of the page, accessible for free (bit.ly/2vQ97Ma), is based on recommendations given by HealthyChildren.org, a website run by the American Academy of Pediatrics.

“Families used to sit together to watch the evening news, which was generated by professional journalists and filtered carefully,” Moreno told Reuters Health by phone. “Now we receive news on our phones, and there are no filters.”

News is always available and bombarding us, even on channels we may not expect, such as social media, where children spend their time, she added.

“You may log onto Facebook to look at cute cats or funny videos and then see a tragic news story,” she said. “This has impacted how adults interact with news, and it’s important to step back and think about kids as well.”

The patient resource explains that adults can help their children by being a calm presence, reassuring them about safety, maintaining a routine and spending extra time together. It’s fine for children to see adults be sad or cry and for families to express their feelings together, though intense emotions may be tougher for children to handle. Tragedies may also present a good time for families to discuss emergency plans and ways they could help survivors and their families.

“It’s always important to talk to kids when things are upsetting them, even if there isn’t a crisis event or big story in the news at the moment,” said Dr. David Schonfeld of the University of Southern California in Los Angeles. Schonfeld, who wasn’t involved with the patient page, researches the best ways to support grieving children.

“In the aftermath of a major event, people are focused on the event itself and less on how to talk to kids,” he told Reuters Health by phone. “You have more energy and capacity to consider how you should approach the discussions when you’re not struggling with the content yourself.”

For children of all ages, the patient page recommends that the best place to start is by asking them what they already know. Parents may be surprised what kids hear elsewhere or what misconceptions may be picked up. Listen carefully and ask what questions they have, and then respond honestly with a focus on the basics and avoid speculating about what might happen next. Most important, listen for underlying fears, remind children that they’re safe and that it’s fine for them to be bothered.

“What we’ve found is that kids are often worried about something you wouldn’t anticipate,” Schonfeld said. “Adults habituate to upsetting daily news, and kids often don’t.”

For younger children, the patient page suggests, graphic images and sounds in news media coverage can be frightening, and having a discussion may be better than showing the news. Young kids may ask more questions about safety and need help separating fantasy from reality. They may also become clingy or regress in behavior, such as wetting the bed or thumb-sucking. Be patient and support children as they process the information.

With older children and teenagers, it may be impossible to avoid news exposure. In fact, they may see it before adults do. To discuss news coverage, try to preview it before watching it together to plan key discussion points. Older kids may ask more questions about the tragedy itself, the recovery efforts and the causes of the event. If they have opinions about preventing future tragedies or helping those in need, listen for their good ideas.

At all ages, children who have difficulty coping may have sleep problems, physical complaints such as headache or stomachache, behavioral changes such as acting less mature or being less patient, or mental health changes such as heightened sadness, depression or anxiety. If you are concerned, talk to your child’s pediatrician.

“We need to talk about what worries them,” Schonfeld said. “If we don’t, we won’t be considered a credible source with additional worries in the future.”